Pediatric Nursing | Neurologic & Cognitive Disorders NCLEX Quiz 10

1. In diagnosing seizure disorder. which of the following is the most beneficial?

Skull radiographs

EEG

Brain scan

Lumbar puncture

The EEG recognizes abnormal electrical activity in the brain. The pattern of multiple spikes can assist in the diagnosis of particular seizure disorders.Option A: Skull radiographs can distinguish fractures and structural abnormalities.Option C: Brain scans confirm space-occupying lesions.Option D: Lumbar puncture confirms problems related to cerebrospinal fluid infection or trauma.

Explanation

The EEG recognizes abnormal electrical activity in the brain. The pattern of multiple spikes can assist in the diagnosis of particular seizure disorders.Option A: Skull radiographs can distinguish fractures and structural abnormalities.Option C: Brain scans confirm space-occupying lesions.Option D: Lumbar puncture confirms problems related to cerebrospinal fluid infection or trauma.

2. The American Association on Mental Deficiency (AAMD). now American Association on Intellectual and Developmental Disabilities (AAIDD) definition of mental retardation emphasizes which of the following?

An IQ level that must be below 50

Cognitive impairment occurring after age 22 years

Deficits in adaptive behavior with intellectual impairment

No responsiveness to contact

Mental retardation is part of a broad category of developmental disability and is defined by the American Association of Mental Deficiency as “significantly subaverage. general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period (18 years of age).”Option A: IQ of 70 or below is considered significantly subaverage intellectual functioning.Option B: Cognitive impairment isn’t part of the definition. However. the definition does states that the impairment or compromise must occur before age 18 years old.

Explanation

Mental retardation is part of a broad category of developmental disability and is defined by the American Association of Mental Deficiency as “significantly subaverage. general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period (18 years of age).”Option A: IQ of 70 or below is considered significantly subaverage intellectual functioning.Option B: Cognitive impairment isn’t part of the definition. However. the definition does states that the impairment or compromise must occur before age 18 years old.

3. Daya's child is scheduled for surgery due to myelomeningocele; the primary reason for surgical repair is which of the following?

To prevent hydrocephalus

To reduce the risk of infection

To correct the neurologic defect

To prevent seizure disorders

Surgical closure decreases the risk of infection stemming from damage to the fragile sac. which can lead to meningitis.Option A: Surgical repair does not help relieve hydrocephalus. In fact. some researchers believe that repair exaggerates the Arnold-Chiari malformation and decreases the absorptive surface for cerebrospinal fluid. leading to more rapid development of hydrocephalus.Option C: The neurologic deficit cannot be corrected. However. some surgeons believe that early surgery reduces risk of stretching spinal nerves and preventing further damage.Option D: Surgical repair of the sac doesn’t prevent seizure disorder. an impairment of the brain neuron tissue.

Explanation

Surgical closure decreases the risk of infection stemming from damage to the fragile sac. which can lead to meningitis.Option A: Surgical repair does not help relieve hydrocephalus. In fact. some researchers believe that repair exaggerates the Arnold-Chiari malformation and decreases the absorptive surface for cerebrospinal fluid. leading to more rapid development of hydrocephalus.Option C: The neurologic deficit cannot be corrected. However. some surgeons believe that early surgery reduces risk of stretching spinal nerves and preventing further damage.Option D: Surgical repair of the sac doesn’t prevent seizure disorder. an impairment of the brain neuron tissue.

4. Reye's syndrome is a rare and severe illness affecting children and teenagers. Its development has been linked with the use of aspirin and which of the following?

Meningitis

Encephalitis

Strep throat

Varicella

Reye’s syndrome has been linked with the ingestion of aspirin in children with viral infections like varicella.Option A and C: There is no association between meningitis or bacterial infections such as strep throat and the development of Reye’s syndrome.Option B: Encephalitis is a component of Reye’s syndrome.

Explanation

Reye’s syndrome has been linked with the ingestion of aspirin in children with viral infections like varicella.Option A and C: There is no association between meningitis or bacterial infections such as strep throat and the development of Reye’s syndrome.Option B: Encephalitis is a component of Reye’s syndrome.

5. After explaining to the parents about their child's unique psychological needs related to a seizure disorder and possible stressors. which of the following interests uttered by them would indicate further teaching?

Feeling different from peers

Poor self-image

Cognitive delays

Dependency

Children with seizure disorders do not necessarily have cognitive delays.Option A. B. and D: Feelings of being different from peers. poor self-image. and dependency can put additional stress on a child trying to understand and manage chronic illness.

Explanation

Children with seizure disorders do not necessarily have cognitive delays.Option A. B. and D: Feelings of being different from peers. poor self-image. and dependency can put additional stress on a child trying to understand and manage chronic illness.

6. Tiffany is diagnosed with increased intracranial pressure (ICP); which of the following if stated by her parents would indicate a need for Nurse Charlie to reexplain the purpose for elevating the head of the bed at a 10 to 20-degree angle?

Help alleviate headache

Increase intrathoracic pressure

Maintain neutral position

Reduce intra-abdominal pressure.

Head elevation decreases. not increases. intrathoracic pressure.Option A. C. and D: Elevating the head of the bed in a child with increased ICP helps to alleviate headache. maintain neutral position. and reduce intra-abdominal pressure. which may contribute to increased ICP.

Explanation

Head elevation decreases. not increases. intrathoracic pressure.Option A. C. and D: Elevating the head of the bed in a child with increased ICP helps to alleviate headache. maintain neutral position. and reduce intra-abdominal pressure. which may contribute to increased ICP.

7. Nurse Gloria is teaching the Mr. and Mrs. Diaz about the early signs and symptoms of lead poisoning; which of the following if stated by the couple would indicate the need for further understanding of the case?

Anemia

Seizures

Irritability

Anorexia

Seizures usually are associated with encephalopathy. a late sign of lead poisoning. Typically. lead levels have already exceeded 70 mg/dl.Option A. C. and D: Anemia. irritability. and anorexia are early signs.

Explanation

Seizures usually are associated with encephalopathy. a late sign of lead poisoning. Typically. lead levels have already exceeded 70 mg/dl.Option A. C. and D: Anemia. irritability. and anorexia are early signs.

8. A child diagnosed with intellectual disability (ID) is under the supervision of Nurse Tasha. The nurse is aware that the signs and symptoms of mild ID include which of the following?

Few communication skills

Lateness in walking

Mental age of a toddler

Noticeable developmental delays

Mild intellectual disability is minimally noticeable in young children. with one of the signs being a delay in achieving developmental milestones. such as walking at a later stage.Option A and C: Severe intellectual disability is marked by the mental age of a toddler and little or no communication skills.Option D: Children with moderate intellectual disability have noticeable developmental delays.

Explanation

Mild intellectual disability is minimally noticeable in young children. with one of the signs being a delay in achieving developmental milestones. such as walking at a later stage.Option A and C: Severe intellectual disability is marked by the mental age of a toddler and little or no communication skills.Option D: Children with moderate intellectual disability have noticeable developmental delays.

9. Nurse Lorna is assessing infantile reflexes in a 9-month-old baby; which of the following would she identify as normal?

Persistent rooting

Bilateral parachute

Absent moro reflex

Unilateral grasp

The parachute reflex appears to about 9 months of age is normal.Option A. C. and D: All of the following are considered abnormal when evaluating infantile reflexes: reflexes that persist after they should have disappeared (rooting). reflexes are absent when they should be present (Moro). and reflexes that are unilateral (grasp).

Explanation

The parachute reflex appears to about 9 months of age is normal.Option A. C. and D: All of the following are considered abnormal when evaluating infantile reflexes: reflexes that persist after they should have disappeared (rooting). reflexes are absent when they should be present (Moro). and reflexes that are unilateral (grasp).

10. Nurse Maritza is caring for a child with Category A Near Drowning; she should do which of the following? (Select all that apply.)

Give furosemide as ordered.

Check for increased intracranial pressure

Plan for discharge in 12 to 24 hours.

Check for electrolyte imbalances.

Keep mechanical ventilation.

Provide oxygen as ordered.

Children with Category A Near Drowning are awake with minimal injury. Care includes checking electrolyte status. administering oxygen and warming. and preparing for discharge in 12 to 24 hours.

Explanation

Children with Category A Near Drowning are awake with minimal injury. Care includes checking electrolyte status. administering oxygen and warming. and preparing for discharge in 12 to 24 hours.

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